What is a decrease in the height of the intervertebral discs. Reducing the height of the lumbar intervertebral discs
Such a pathological process as a decrease in height intervertebral discs, a fairly common occurrence. This disease affects the intervertebral discs and surfaces of other articular parts. Insufficient therapy of the disease can lead to the development of vertebral instability, the formation of hernias or ankylosis.
Causes of a decrease in the height of the intervertebral discs
Intervertebral discs are a formation cartilage tissue consisting of annulus fibrosus and nucleus pulposus. It performs a shock-absorbing function, affects the flexibility of the spine, supports motor activity spinal column fine. Its supply of nutrients occurs by diffusion with the help of periarticular soft tissues, since the cartilaginous formation itself does not have blood vessels. With insufficient nutrition, the body of the disc is dehydrated, decreases in height, the fibrous ring can spread. At running forms diseases form growths - osteophytes. This condition greatly reduces the motor activity of the affected area. The decrease in the height of the disks occurs due to the following reasons:
People of "sedentary" professions are at risk of spinal diseases. - constant presence in a sitting position;
- poor circulation;
- metabolic disease;
- physiological changes;
- diseases of the musculoskeletal system;
- injury.
An unhealthy lifestyle, obesity, constant stress or pregnancy can provoke changes in the height of the intervertebral discs.
Manifestations
Reducing the height of the intervertebral discs occurs in 4 stages, which are described in the table:
| Stage | Description of pathology | Symptoms |
| 1 | The shell of the fibrous ring undergoes minor changes, but the height of the opening of the cracks does not change. | Stiffness in movement after waking up, discomfort during physical activity |
| 2 | The disc shrinks, the fibrous membrane deforms, the periarticular muscles and ligaments become unyielding | Pain occurs during freezing in certain positions or during physical activity |
| 3 | Uneven spreading of the disc ring is observed, hernias, swelling, inflammation of the affected areas of the spine may appear | Pinched blood vessels and nerves bring severe pain, numbness, pathology internal organs |
| 4 | Osteophytes occur, the height of the discs is significantly reduced, joint fusion is possible | Immobility of the affected area or paralysis |
How is it diagnosed?
A study with high accuracy will establish the degree of damage to the tissues of the spine. For staging correct diagnosis you need to contact a specialist, for example, a neurologist. To begin with, the doctor must collect a reliable history, conduct tactile and visual examinations. Then additional diagnostic studies to confirm the diagnosis. These include:
- X-ray. Helps detect small changes in different structures vertebrae, e.g. discs cervical.
- MRI. It will make it possible to notice pathological abnormalities in the spinal cord or to detect the formation of hernias, for example, lumbar.
- EMG. Diagnoses pinching, trauma to nerve endings.
- Discography. Shows all manifestations of changes in the intervertebral discs.
Treatment Methods
For effective therapy, several complexes of influence are used. The attending physician prescribes physiotherapeutic procedures, massages, ridge extraction, exercise therapy, development muscular system, medical treatment. IN rare cases conservative methods influences do not help, then it is carried out surgical intervention. It is impossible to completely get rid of changes in the height of the intervertebral discs. Therapy will only help improve the patient's condition and slow down the progression of the disease. At drug treatment prescribe drugs that are presented in the table.
Complications
When the annulus is ruptured, the contents of the nucleus pulposus are squeezed out. A number of complications can occur not only with insufficient nutrition of the vertebral parts. A change in the height of the intervertebral cartilage formation is observed after injuries or strong physical exertion. There are two types of complications that develop in parallel with this pathology:
- Protrusion. The body of the disk is subjected to compression, the nucleus begins to bulge, the integrity of the fibrous ring is preserved.
- Herniated discs. The annulus fibrosus ruptures, and the nucleus pulposus flows beyond the border of the location. If the pressure continues, the size of the hernia increases.
How to warn?
To avoid the development of pathologies of the musculoskeletal system, it is necessary to maintain healthy lifestyle life. It is advisable to monitor the amount of water you drink to maintain correct exchange substances, do not injure the spine, avoid lifting weights. With sedentary work, it is necessary to take breaks to warm up the muscular system. It is also recommended not to expose the body to hypothermia and stress. It is important to have regular medical checkups.
Spinal problems are a concern for many. modern people leading a passive lifestyle. A decrease in the height of the intervertebral discs is observed in 80% of people on the globe who have reached the age of 50-60 years. Pathological changes occur gradually and cause instability of the vertebrae, hernia and curvature of posture.
Intervertebral discs are connective cartilage tissue that fixes the vertebrae of the ridge in one position. It is from them normal state depends on the mobility and flexibility of the spine, the ability to maintain a normal active life. Thanks to special structure fabrics, they act as shock absorbers when running, jumping, bending and other movements. Constant exposure to a number negative factors leads to wear and sagging of the discs.
How does defeat develop?
Intervertebral discs consist of a soft core and a dense shell - the fibrous ring, enclosed in hyaline plates. This cartilage lacks blood vessels, which means that they are fed from neighboring soft tissues. Normal muscle development, adequate loads on the body and no problems with circulatory system help keep the discs between the vertebrae healthy.
The appearance of degenerative changes in the body (the development of osteochondrosis), a passive lifestyle, sedentary work, lack of sports - all this leads to stiffness of movements, pain in the back when turning, as well as swelling and spasms.
They, in turn, seriously aggravate blood circulation, which worsens the condition of the pathological area. Over time, discs lose water and cease to be flexible, microcracks appear. As a result, over time, the height intervertebral disc decreases.
Reducing the height of the intervertebral discs is the first stage of degenerative-dystrophic changes in the spine
Causes
The main reason for the appearance of pathology in people of any age is a slowdown in metabolism in the body, impaired blood flow and nutrient deficiency in cartilage tissue. But, besides this, the following factors can affect the malnutrition in the intervertebral discs and reduce their height:
- unbalanced diet;
- obesity;
- changes in tissues with age;
- trauma or stress;
- infectious processes;
- pregnancy;
- stress and metabolic disorders in tissues.
Determination of the cause allows you to choose the most effective therapy intervertebral disc and achieve improvements in the treatment of short term. The first step to restoring normality is to eliminate the underlying factors that led to the formation of the problem.
Symptoms of the disease
signs pathological changes depend largely on the stage and localization. Conditionally, the disease proceeds in several stages:
- Initial . Disk damage is minor, so the appearance of a problem for many goes unnoticed. Patients in this phase complain only of stiffness of movements in the first hours after waking up, as well as the appearance of discomfort in the back during physical exertion.
- Second . Degenerative changes in the disc continue to progress. Characteristic subsidence and defects are observed fibrous membrane. At this stage, the appearance of curvature of the spine is noticeable. thoracic, instability of individual vertebrae, as well as severe pain during long stay in an uncomfortable position.
- Active . At this stage, cracks appear in the disc, or it begins to go beyond the anatomical limits. The characteristic signs of this stage are swelling, inflammation, muscle spasms, decreased sensitivity individual areas or limbs.
- Progressive. At this stage, a noticeable decrease in the height of the intervertebral discs, their exit beyond the vertebra and the formation of osteophytes. Signs of pathology are the loss of mobility of the segment, paralysis of the limb and dysfunction of internal organs, often leading to complete disability.
Pain in the affected parts of the spine is the first and constant symptom
It is worth contacting a specialist when the first symptoms appear. The sooner treatment is started, the higher the chance of a favorable outcome.
Diagnostic studies
Today, experts use a variety of modern techniques to conduct diagnostic procedures in order to detect the pathology of the intervertebral disc at an early stage.
When the first signs appear, they turn to a neurologist, who, after a visual examination, questioning the patient and studying the anamnesis, prescribes the following studies:
- X-ray. It allows you to detect violations in the cervical region even at the stage when symptoms are not observed.
- MRI. assigned where x-ray examination not effective (for diagnosing intervertebral hernias on initial stage). With the help of such a device, you can notice all the degenerative changes in the trunk of the spine.
- Electroneurography. Allows you to discover characteristic processes in the nerve pathways or their damage.
- Discography. Allows you to examine the damage in the disk structure.
The neuropathologist selects the treatment, based on the information after the examination and the clinical picture.
Features of treatment
Reducing the height of the intervertebral discs is treated in a conservative way, medication or surgery, depending on the patient's condition, the localization of the problem, the stage of the disease. In some cases, the progression of the disease and the growth of osteophytes only slow down or stop a little, which improves the condition of the cartilage in general. All actions are aimed at eliminating the pain syndrome, improving blood circulation and metabolic reactions, as well as restoring disc mobility.
Treatment is necessarily complex and includes several of the following activities:
- physiotherapy and manual procedures;
- study of the joint to improve the movement of lymph and blood;
- physiotherapy;
- swimming or yoga;
- massotherapy;
- cryotherapy;
- spinal traction (natural, hardware or water);
- procedures to strengthen muscle, bone and ligament structures of the body.
All this is accompanied by taking painkillers to eliminate discomfort in the region of the discs of the cervical region or other area, as well as medicines to relieve inflammation and replenish cartilage tissue. For some time, the patient is recommended to wear a supporting corset, complete failure from bad habits and dieting.
Regular classes physical therapy help to avoid complications of osteochondrosis
Preventive actions
Herniated disc l5 s1 is treated for a long time and is difficult, so every person at risk should take care of high-quality prevention. It will allow to exclude a decrease in the height of discs of other localization, which will protect against possible other complications. The main methods of prevention are:
- regular proper nutrition;
- body weight control, exclusion of the appearance of extra pounds;
- constant maintenance of water balance;
- exclusion of stressful situations;
- performance of special gymnastics;
- quitting smoking and alcohol;
- regular sports.
Such simple actions will strengthen the muscular frame and establish metabolic processes between the lumbar discs and neighboring tissues. This will provide support for their normal height and spine health.
Reducing the height of the intervertebral discs of the lumbar spine is currently a fairly common pathology. Everyone knows that the human spine plays the role of a bearing axis. It supports the entire human body, and thanks to the intervertebral discs, it performs a shock-absorbing function. He protects spinal cord from injury. The spine consists of separate parts - the vertebrae.
Causes of the appearance of pathology
Between the individual parts of the spine there are intervertebral discs, which perform a shock-absorbing function. They consist of the following parts:
- nuclei - fibrous tissue having a cartilaginous structure;
- ring, consisting of tissue similar to tendon.
For all its functionality, the intervertebral discs do not have vessels in the structure. So they get nutrients from the tissues around them. And if these tissues for some reason cease to receive nutrition, then the intervertebral discs "experience hunger." Between themselves, the parts of the spine are connected directly by the nucleus of the disc. And with a limited intake of nutrients:
- 1 Disc tissues are dehydrated.
- 2 Intervertebral discs become fragile and lose their height.
And if the process of tissue nutrition is not restored, then the cartilaginous tissues of the disc harden and appearance remind bone tissue. This process is called osteochondrosis (spondylosis). But such a disease can also be caused by another reason - mechanical compression of the disc. This happens with injuries of the spine, with unbearable loads.
Several pathologies are possible:
- 1 Protrusion - if there is no damage to the fibrous ring.
- 2 Herniated disc - if such violations lead to the destruction of the ring and the displacement of the ring beyond its limits.
What can happen after a decrease in the height of the intervertebral discs?
- At the third stage, the destruction of the disc ring continues and a hernia is formed. At this stage of the lesion, the disc is less than half the norm. At this time there are:
- In the second stage, the fibrous ring changes. At this stage already infringed nerve endings(this leads to pain). The blood and lymph outflows are already disturbed, and the height of the intervertebral disc is less than the norm by a quarter.
- First stage. Slight inconvenience (discomfort). Basically, they happen only in the morning, over time, a person "paces around." At this stage, it is extremely rare to see a doctor.
- 1 scoliosis is the bending of the spine in one direction or another;
- 2 kyphosis - the formation of a hump;
- 3rd lordosis - backward bending of the spine.
- The fourth stage is last step in spinal deformities. At this stage, there is a shift and compaction of the damaged vertebrae. This is a painful process. Patients feel strong sharp pain when walking, the mobility of the joint is minimized. The height of the disc is already less than half of the norm. At this stage of the development of the disease, it is possible to establish a disability for the patient.
Lumbar osteochondrosis is manifested by such symptoms:
- 1 When tilting and sudden movements of pain in the lower back. Causes discomfort and uncomfortable posture during sleep. severe pain in the lumbar spine in the morning.
- 2 Pain in hip joint And lower limb. At this time, areas with numbness and burning are formed. The patient experiences pain in the legs, and sometimes backache.
Prevention and treatment of the disease
Prevention of a decrease in the height of the intervertebral discs is quite simple:
- 1 You need to eat right and balanced.
- 2 Health-improving gymnastics is very important for disease prevention.
- 3 Need to support water balance in organism. To do this, you need to drink at least 2 liters of water per day. Water helps maintain proper metabolism in the human body.
- 4 Control the weight being lifted - do not lift anything heavy.
- 5 It is necessary to be protected from injuries, stress and hypothermia.
- 6 Be sure to periodically undergo a preventive examination of the spine.
How is the treatment carried out lumbar osteochondrosis? After a thorough examination of the patient by a neurologist, various examinations and analyzes are prescribed: X-ray, MRI, CT, etc.
The prescribed treatment is aimed at relieving pain in the patient, freeing from pinched nerve roots.
And among other things, the treatment is aimed at stopping the process of disc destruction.
The main methods of treatment:
- 1 Medical.
- 2 Manual therapy.
- 3 Physiotherapy.
- 4 Therapeutic gymnastics.
- 5 Surgical intervention.
Treatment of osteochondrosis folk remedies just as popular as folk treatment other diseases. This is due to its simplicity and low cost. ethnoscience for the treatment of this disease various tinctures, compresses, rubbing. Do not interfere with baths from sea salt and needles. Such baths help to restore blood circulation and relax the muscles.
It is better to use in the treatment of lumbar osteochondrosis complex treatment diseases. But it should take place only on the prescription of a doctor and under his supervision.
Very often, when applying for an appointment with a therapist with characteristic complaints of pain in the neck and lower back, the patient receives a standard referral for an x-ray. Based on the results of this examination, a professional opinion of the radiologist is given. And it very often contains such a term as a decrease in the height of the disc in the lumbar or cervical region. in the chest and sacral region spine, this pathology is less common. This is due to the limitation of mobility in these departments.
The decrease in the height of the intervertebral discs speaks primarily of severe dehydration (dehydration) of the cartilage tissue. Secondly, this feature for disc protrusion. The condition is a complication of long-term osteochondrosis. In turn, the protrusion of the fibrous ring is the risk of developing a hernial protrusion of the pulpous nucleus. Moreover, a disk rupture can happen at any time. It is impossible to predict the moment of this neurological catastrophe. Therefore, it is necessary to take timely measures for effective and correct treatment.
A decrease in the height of the intervertebral disc is always accompanied by prolapse and protrusion of its boundaries beyond the vertebral bodies. Do not think that this pathology will go away by itself. No, it will only get worse in the future. It is possible to restore the shape of the annulus fibrosus and its depreciation abilities only with the normalization of diffuse nutrition. To do this, you need to activate the work of the muscular frame of the back. And first you need to stop the pain syndrome. This is a treatment plan with methods manual therapy in our clinic.
Moderate decrease in the height of the spinal disc
It is far from always that a decrease in the height of the spinal disc indicates that a stable protrusion has already formed. On early stages pathological process this phenomenon may be transient. Those. under the influence of negative factors, such as emotional stress or physical overload, dehydration of the cartilage tissue occurs. Then, as it improves general condition hydration is restored by diffuse exchange, and disc height is restored.
But even a moderate decrease in the height of the discs should be considered as a negative signal to start the process of restoring the spinal column. In the absence of osteochondrosis and degenerative changes in cartilage fibers, no pathological signs patients may not have. Even under the influence of extreme factors. Even after very strenuous exercise, healthy condition cartilage intervertebral discs restore their anatomical shape within 2-5 hours.
Reducing the height of the intervertebral discs of the lumbar spine
Most often at modern man x-ray image shows a decrease in height intervertebral disc in the lumbar spine and this is far from an accident. There are several reasons increased risk destruction of the fibrous ring in this department:
- sedentary lifestyle and lack of regular physical activity on the muscular frame;
- malnutrition when the diet is rich in fast carbohydrates and refined foods and does not contain at all fresh vegetables and fruits sea fish And omega fatty acids;
- constant injury to the cartilaginous discs during sudden movements, bending, jumping;
- wearing shoes with heels (for women) deforms the entire configuration of the lumbar spine, shifting the physiological center of gravity anteriorly;
- incorrect setting of the foot in the form of flat feet and clubfoot;
- curvature of the spine in the adjacent sections;
- inflammatory processes, rheumatism, etc.
It is worth noting that a decrease in the height of the lumbar discs rather quickly leads to the formation of a hernial protrusion of the nucleus pulposus. Therefore, with radiographic signs of a decrease in the height of the intervertebral discs, effective treatment should be started immediately.
In our clinic of manual therapy, patients are invited to receive a free consultation from a leading specialist. During the appointment, the doctor will talk about how the treatment can be carried out and what potential results can be obtained.
Reducing the height of the intervertebral discs of the cervical region
Very often in the pictures a decrease in height is determined. cervical discs C4-C5 and C5-C6, since they account for the main static load when performing certain actions during monotonous work. Accordingly, people engaged in sedentary work in offices are susceptible to pathology.
A decrease in the height of the cervical discs is accompanied by serious painful sensations in the collar area. At the end labor day the patient experiences severe tension in the muscles of the neck and an attack of headache with localization in the back of the head. There may be sensations of muscle weakness and numbness in the upper limbs.
If you do not treat a decrease in the height of the intervertebral discs of the cervical region, this can lead to the development of the syndrome vertebral artery. It will be expressed in violation of the blood supply to the posterior cerebral structures. May cause an increase blood pressure, severe headaches, dizziness, decreased mental performance, depression.
For the treatment of cervical protrusion, it is better to use manual therapy methods. This will effectively and safely restore the height of the intervertebral disc and eliminate the risk of comorbidities.
Fixation of the spine in spondylolisthesis, lowering the height of the intervertebral disc - spinal fusion bone allo- or autografts are neurosurgical operations performed to create immobility between adjacent vertebrae in case of ineffectiveness conservative treatment degenerative-dystrophic pathology of the intervertebral disc, instability of the spinal segment, spinal deformity, spondylolisthesis.
The intervertebral disc performs the function of "damping" movements. When it is removed, the biomechanics of the spine is disturbed, there is a risk of developing instability and pain. If the mobility in the segment is more than the permissible value by 5 - 7% - such a segment is unstable and can provoke infringement of the nerve and muscle structures, increase pressure on the joints, leading to degeneration and arthrosis - pain syndrome. Spondylolisthesis- "slipping", displacement of the body of the overlying vertebra.
Spinal fusion stabilizes the vertebrae and discs by creating a connection - fusion of adjacent vertebrae. This excludes any movement between fixed vertebrae. With spinal fusion in one segment, the patient does not feel the restriction of mobility.
Developed different techniques and methods of surgical technique for performing such operations on different levels spine.
Preparation for operations - standard - general clinical tests, physical examination, x-ray examinations spine - radiographs functional tests, computer and magnetic resonance imaging, discography.
Posterior fusion is performed in case of spinal deformity - scoliosis, kyphosis, spondylolisthesis.
Transforaminal lumbar intercorporeal fusion is performed through the posterior approach, special screws are screwed into the vertebra, the intervertebral disc is removed, a spacer with an implant (possibly taken from pelvic bone patient), in addition, bone implants are installed in the lateral grooves of the vertebra. Screws are attached to the rods and the wound is sutured. Over time, the bone implant “takes root” and fusion of the vertebrae occurs - a fixed fusion.
Stay in the hospital - individually - 3-5 days. In the future, corseting, limiting loads, and rehabilitation are recommended - an average of 6 weeks.
For operations with degenerative changes intervertebral discs in combination with spondylolisthesis at the levels of the lumbar spine - L2-S1, with prolonged pain syndrome and inefficiency conservative therapy it is possible to use the B-Twin implant. This operation can be performed open method– through an anterior or posterior approach or through a posterolateral approach percutaneously.
According to the results of the examination, the doctor chooses the method of operation and access, the size of the implant is selected. A discectomy is performed, the folded implant is placed in the intervertebral space and moved apart.
Contraindications to the use of the implant are quite extensive and the possibility of its use is decided by the neurosurgeon. Metabolic bone disease, neurofibromatosis, osteoporosis, tuberculosis, immunodeficiency, malignant formations- not the whole list of contraindications. The physician must be informed of previous diseases, previous treatment (for any reason), the duration of taking hormones, calcitonin, vitamin D ..., the presence drug allergy and allergies to metals.
Complications - complications of anesthesia - allergic reactions, damage nervous structures, infectious complications, unsatisfactory fusion of the vertebrae, the need for a second operation, ongoing pain.
Spondyloptosis L5. Two-stage operation - resection of the L5 body and fixation of the lumbosacral region (L3-L4-S1) with the CDI and TSRH system, L4-S1 interbody fusion with Interfix cages.
The Vertex Select reconstructive system is used during operations on the cervical spine to fix the vertebrae and the occipital bone.
An alternative to immobile fusion of the vertebral bodies has been developed by the technique of an artificial intervertebral disc. With this operation, the movement between the vertebrae is restored. The operation is performed through transabdominal access, the contents abdominal cavity is moved aside, the affected disc is removed, two plates are installed instead of it and a plastic “support” is installed between them, which ensures the mobility of the vertebrae.
Motion6 Implant - C6 intervertebral disc prosthesis is used to replace the disc at the cervical level - C6 and provides mobility of the cervical spine.
Intradiscal electrothermal therapy (IDET) is a method of electrocoagulation of the disc, its strengthening, “stitching”. A catheter with an electrode is inserted into the damaged disc, an electric current is applied.
Surgical treatment achieves stable fixation of spinal structures, decompression of nerve structures, restoration of spinal biomechanics, prevention of irreversible changes in the affected segment, early activation, shortening of hospital stay and rehabilitation.
Neurologist Kobzeva S.V.
